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General NPI Number Information
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NPI Number | 1831643543
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Entity Type | Organization
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Legal Business Name | YOUNGWOO ACUPUCTURE & HERBS CLINIC
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Dates
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Enumeration Date | 08/10/2016
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 4372 ROBIN DR
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City | LA PALMA
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State | CA
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Zip | 90623-1933
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Country | US
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Telephone | 714-886-7432
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Fax |
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Provider Business Mailing Address
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Address Line | 7002 MOODY ST STE 111A
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City | LA PALMA
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State | CA
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Zip | 90623-1181
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Country | US
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Telephone | 714-820-3208
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Fax |
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURIST
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Name | YOUNGWOO LEE
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Credential |
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Telephone | 714-820-3208
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC17209
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License Number State | CA
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